タイトル(別表記) Hospital and clinic cooperation for the treatment of rheumatoid arthritis in Okayama Prefecture, Japan
フルテキストURL 126_209.pdf
著者 佐田 憲映| 西田 圭一郎| 山中 隆夫| 三崎 健太| 若林 宏| 篠田 潤子| 髙木 徹| 矢野 隆介| 中村 明彦| 難波 良文| 守田 吉孝| 小山 芳伸| 山本 惠嗣| 江澤 和彦| 太田 裕介| 吉原 由樹| 三好 信也| 棗田 将光| 臼井 正明| 吉永 泰彦| 林 充| 山村 昌弘| 橋詰 博行|
抄録 Objective: To survey the current status and problems of cooperation between clinics and hospitals in Okayama Prefecture, Japan for the treatment of rheumatoid arthritis (RA).  Methods: We distributed a questionnaire to 300 of the 983 Okayama Prefecture clinics that had either an internal medicine or orthopedic surgery department, from December 2013 to February 2014. The questionnaire covered practice pattern for RA treatment in clinics, current status of the hospital and clinic cooperation, and acceptance of the biologic therapy.  Results: One hundred clinics responded to the questionnaire. Seventy percent of the clinics reported making referrals to rheumatologists before the initiation of RA treatment, and half of the other 30% of the clinics administered methotrexate as the first-line treatment for RA by their own decision. Sixty-six clinics cooperated with flagship hospitals, conducting medical and laboratory examinations, providing prescriptions, and treating common diseases of patients. These clinics expected the cooperating rheumatologists to follow-up patients every 3 to 6 months and to make the diagnosis, make decisions regarding RA treatment changes, and perform surgery. Seventy-one percent of the clinics responded that cooperation with a hospital is possible even for patients who are administered biologics. As reasons for no cooperation with the flagship hospitals, clinics noted the lack of information about rheumatologists in the area and recent trends in the management of RA.  Conclusion: The current study reported, for the first time, the actual conditions of management of RA in clinics, as well as future problems of hospital and clinic cooperation in Okayama Prefecture.
キーワード 病診連携(hospital and clinic cooperation) 関節リウマチ(rheumatoid arthritis) 生物学的製剤(biologics) メトトレキサート(methotrexate)
備考 原著 (Original Paper)
出版物タイトル 岡山医学会雑誌
発行日 2014-12-01
126巻
3号
出版者 岡山医学会
出版者(別表記) Okayama Medical Association
開始ページ 209
終了ページ 215
ISSN 0030-1558
NCID AN00032489
資料タイプ 学術雑誌論文
言語 Japanese
著作権者 Copyright (c) 2014 岡山医学会
論文のバージョン publisher
査読 有り
DOI 10.4044/joma.126.209
NAID 130004903246
Sort Key 6
Eprints Journal Name joma
参考文献 1) Kosinski M, Kujawski SC, Martin R, Wanke LA, Buatti MC, Ware JE Jr, Perfetto EM : Health-related quality of life in early rheumatoid arthritis : impact of disease and treatment response. AJMC (2002) 8, 231-240. 2) Scire CA, Lunt M, Marshall T, Symmons DP, Verstappen SM : Early remission is associated with improved survival in patients with inflammatory polyarthritis : results from the Norfolk Arthritis Register. Ann Rheum Dis (2014) 73, 1677-1682. 3) Aga AB, Lie E, Uhlig T, Olsen IC, Wierod A, Kalstad S, Rodevand E, Mikkelsen K, Kvien TK, Haavardsholm EA : Time trends in disease activity, response and remission rates in rheumatoid arthritis during the past decade : results from the NOR-DMARD study 2000-2010. Ann Rheum Dis (2013). doi : 10.1136/annrheumdis-2013-204020. 4) Smolen JS, Landewe R, Breedveld FC, Buch M, Burmester G, Dougados M, Emery P, Gaujoux-Viala C, Gossec L, Nam J, Ramiro S, Winthrop K, et al. : EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs : 2013 update. Ann Rheum Dis (2014) 73, 492-509. 5) 山崎 秀, 鈴木明夫, 金物壽久, 浦野房三, 鈴木貞博, 松田正之, 加藤博之 : 関節リウマチの生物学的製剤治療における医療連携上の問題点. 中部リウマチ(2010)40, 86-87. 6) 小林 彩, 吉川美香, 小川英作, 奥山隆平 : 長野県における乾癬治療の現状と病診連携の可能性. 西日本皮膚科(2013)75, 346-349.
タイトル(別表記) Molecular target therapies in rheumatic diseases
フルテキストURL 126_227.pdf
著者 若林 宏|
キーワード リウマチ性疾患 自己免疫疾患 生物学的製剤 分子標的薬
備考 特集 (Feature Articles)
出版物タイトル 岡山医学会雑誌
発行日 2014-12-01
126巻
3号
出版者 岡山医学会
出版者(別表記) Okayama Medical Association
開始ページ 227
終了ページ 230
ISSN 0030-1558
NCID AN00032489
資料タイプ 学術雑誌論文
言語 Japanese
著作権者 Copyright (c) 2014 岡山医学会
論文のバージョン publisher
査読 有り
DOI 10.4044/joma.126.227
NAID 130004903237
Sort Key 9
Eprints Journal Name joma
参考文献 1) Takeuchi T, Miyasaka N, Tatsuki Y, Yano T, Yoshinari T, Abe T, Koike T : Baseline tumour necrosis factor alpha levels predict the necessity for dose escalation of infliximab therapy in patients with rheumatoid arthritis. Ann Rheum Dis (2011) 70, 1208-1215. 2) Takeuchi T, Yamanaka H, Ishiguro N, Miyasaka N, Mukai M, Matsubara T, Uchida S, Akama H, Kupper H, Arora V, Tanaka Y : Adalimumab, a human anti-TNF monoclonal antibody, outcome study for the prevention of joint damage in Japanese patients with early rheumatoid arthritis : the HOPEFUL 1 study. Ann Rheum Dis (2014) 73, 536-543. 3) Palframan R, Airey M, Moore A, Vugler A, Nesbitt A : Use of biofluorescence imaging to compare the distribution of certolizumab pegol, adalimumab, and infliximab in the inflamed paws of mice with collagen-induced arthritis. J Immunol Methods (2009) 348, 36-41. 4) Singh JA, Christensen R, Wells GA, Suarez-Almazor ME, Buchbinder R, Lopez-Olivo MA, Ghogomu ET, Tugwell P : A network meta-analysis of randomized controlled trials of biologics for rheumatoid arthritis : a Cochrane overview. CMAJ (2009) 181, 787-796. 5) Dougados M, Kissel K, Sheeran T, Tak PP, Conaghan PG, Mola EM, Schett G, Amital H, Navarro-Sarabia F, Hou A, Bernasconi C, Huizinga TW : Adding tocilizumab or switching to tocilizumab monotherapy in methotrexate inadequate responders : 24-week symptomatic and structural results of a 2-year randomised controlled strategy trial in rheumatoid arthritis (ACT-RAY). Ann Rheum Dis (2013) 72, 43-50. 6) Axmann R, Herman S, Zaiss M, Franz S, Polzer K, Zwerina J, Herrmann M, Smolen J, Schett G : CTLA-4 directly inhibits osteoclast formation. Ann Rheum Dis (2008) 67, 1603-1609. 7) Ottaviani S, Moltó A, Ea HK, Neveu S, Gill G, Brunier L, Palazzo E, Meyer O, Richette P, Bardin T, Allanore Y, Lioté F, et al. : Efficacy of anakinra in gouty arthritis : a retrospective study of 40 cases. Arthritis Res Ther (2013) 15, R123. 8) Stone JH, Merkel PA, Spiera R, Seo P, Langford CA, Hoffman GS, Kallenberg CG, St Clair EW, Turkiewicz A, Tchao NK, Webber L, Ding L, et al. : Rituximab versus cyclophosphamide for ANCA-associated vasculitis. N Engl J Med (2010) 363, 221-232. 9) Mukhtyar C, Guillevin L, Cid MC, Dasgupta B, de Groot K, Gross W, Hauser T, Hellmich B, Jayne D, Kallenberg CG, Merkel PA, Raspe H, et al. : EULAR recommenda-tions for the management of primary small and medium vessel vasculitis. Ann Rheum Dis (2009) 68, 310-317.
著者 Yamamoto, Goki| Tanabe, Masatada| Wakabayashi, Hiroshi| Hashimoto, Gonosuke| Yamamoto, Michio|
発行日 1974-10
出版物タイトル Acta Medica Okayama
28巻
5号
資料タイプ 学術雑誌論文
著者 Wakabayashi, Hiroshi| Ito, Toshihiro| Fushimi, Soichiro| Nakashima, Yuki| Itakura, Jyunya| Liu, Qiuying| Win, Min Min| Sun, Cuiming| Chen, Cao| Sato, Miwa| Mino, Megumi| Ogino, Tetsuya| Makino, Hirofumi| Yoshimura, Akihiko| Matsukawa, Akihiro|
発行日 2012-09
出版物タイトル Clinical Immunology
144巻
3号
資料タイプ 学術雑誌論文
JaLCDOI 10.18926/AMO/47015
フルテキストURL 65_5_329.pdf
著者 Matsumoto, Yoshinori| Sada, Ken-ei| Takano, Mariko| Toyota, Noriko| Yamanaka, Ryutaro| Sugiyama, Koichi| Wakabayashi, Hiroshi| Kawabata, Tomoko| Otsuka, Fumio| Makino, Hirofumi|
抄録 It is well known that infection is one of the major causes of morbidity and mortality in rheumatic disease patients treated with high-dose glucocorticoids, especially in the early phase after achievement of disease remission. The aim of this study was to identify the risk factors for infection, with a focus on the dose of glucocorticoids administered, following the achievement of disease remission in rheumatic diseases patients. We retrospectively analyzed the medical records of rheumatic disease patients who had been treated with glucocorticoids. The primary endpoint was the incidence rate of infection during a period from 1 to 2 months after the commencement of treatment. From April 2006 to March 2010, 19 of 92 patients suffered from infection during the observation period. Age≧65 yrs, presence of interstitial pneumonia, diagnosis of systemic vasculitis and serum creatinine level≧2.0mg/dl were found to be univariate predictors for infection. However, only the presence of interstitial pneumonia was an independent risk factor for infection (HR=4.50, 95%CI=1.65 to 14.44) by the Cox proportional hazard model. Even after achievement of clinical remission, careful observation is needed for patients with interstitial pneumonia, more so than for those receiving high-dose glucocorticoids.
キーワード infection rheumatic disease glucocorticoids interstitial pneumonia risk factors
Amo Type Original Article
発行日 2011-10
出版物タイトル Acta Medica Okayama
65巻
5号
出版者 Okayama University Medical School
開始ページ 329
終了ページ 334
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
OAI-PMH Set 岡山大学
著作権者 CopyrightⒸ 2011 by Okayama University Medical School
論文のバージョン publisher
査読 有り
Submission Path amo/vol65/iss5/7
PubMed ID 22037270
Web of Sience KeyUT 000296116400007